Thousands of Illinois Medicaid enrollees could lose coverage under new federal eligibility rules that took effect Wednesday, with additional changes to the program coming in the months ahead.

Eligibility requirement changes impacting noncitizens without a green card took effect Oct. 1. The changes are part of the federal law signed by President Donald Trump in July, formally known as the One Big Beautiful Bill Act.

The changes are one of several in the law that are aimed at slashing nearly $1 trillion out of the Medicaid program over the next 10 years, Capitol News Illinois reported. More than 3.2 million Illinoisans are enrolled in Medicaid.

Tom Bowman is CEO of Community Health Care, Inc., based in the Quad Cities. He said the overall changes to the coverage – which opens access to health care for families who may not otherwise be able to afford it – will be felt across the medical field.

“It’s going to have a huge impact on our community, and not just on patients under Medicaid,” Bowman said. “It’ll affect the services available at hospitals. It’ll affect the services available at clinics. So it’ll have a larger impact than just the coverage for low-income Illinoisans.”

Those on Medicaid in Illinois who aren’t citizens should have received letter notifications before Thursday advising them of the changes, according to a joint memo from the Illinois departments of Human Services and Healthcare and Family Services, which administers Medicaid to millions of users.

The new rules will end federally funded Medicaid coverage for some noncitizens who previously were eligible, including certain refugees, asylees, humanitarian parolees and survivors of human trafficking, according to HFS. Some people in those categories may remain eligible depending on their current immigration status or other circumstances.

For a full list of eligibility changes, visit www.dhs.state.il.us. To view information in multiple languages, visit www.hfs.illinois.gov.

In June, Gov. JB Pritzker signed a new law meant to protect Illinoisans from the sweeping federal Medicaid changes.

Community Health Care Inc. has clinics across the region that offer primary, preventive, dental, behavioral health, acute and chronic care, along with OB/GYN, lab and pharmacy services. The clinics accept patients from all walks of life, including Medicare and Medicaid users and those without health insurance.

Because when people fear their coverage is gone, they stop seeking needed medical care, said Dr. Glen Davis, chief medical officer of Aetna Better Health of Illinois.

“When the person thinks they’re not sure that they’re still covered, they’re uncertain, the fear is, ‘If I go see a doctor, maybe I’ll incur a big cost,’” Davis said. “Someone living with diabetes or asthma or a chronic condition where they need to see their doctors, they need their medications; not seeking medical care can be very disruptive.”

Davis said the same goes for people suffering from other health conditions or diagnosed with behavioral health issues.

“If you’re anxious or depressed or seeing a therapist, you need to continue that therapy, keep going through medications,” Davis said. “If there’s uncertainty regarding coverage, folks may just stop going and they end up sicker and it becomes more of an acute situation. So maintaining that coverage is key.”

What are the changes that took effect Oct. 1?

As of Oct. 1, noncitizens will remain eligible for Medicaid only if they’re among the following, according to the IDHFS:

• Lawful permanent residents (subject to a 5-year waiting period unless federally exempt)

• Cuban or Haitian entrants

• Migrants who are citizens of Palau, Micronesia, or the Marshall Islands living in the U.S.

• Minors

• Pregnant or in postpartum

Lawful permanent residents who are exempt from the 5-year waiting period include:

• Refugees and asylum seekers

• Cuban or Haitian entrants

• Victims of trafficking, or a relation of someone who’s a trafficking victim

• People granted withholding of deportation

• Members of a federally recognized Indian tribe or American Indian born in Canada

How can I check to see if I’m still covered under Medicaid?

For starters, anyone can visit www.abe.illinois.gov/access for an Applications for Benefits Eligibility form to see if you’re still covered, said Melanie Fernando, CEO of Aetna Better Health, which is owned by CVS Health.

Aetna serves just more than 300,000 patients in Illinois.

Fernando said people shouldn’t automatically assume they’re not going to be eligible under the new regulations, including upcoming work requirement changes that take effect Jan. 1.

“There is some uncertainty and there’s also different requirements for different subpopulations, and we want to make sure it’s crystal clear who has what requirement,” Fernando said. “I think that’s going to be some of the challenges as we go through the next few months.

Another important step for anyone should be to contact their Medicaid provider, health experts said.

Check your mail. Check your email. Medicaid users likely will have been notified of the changes in multiple ways by now, experts said.

Some other changes that take effect Jan. 1 will require Medicaid users to do what Davis called “redetermination.”

They might need to reapply for Medicaid coverage every six months. They may face additional requirements based on their employment, student or other work requirements.

Seeking care now can save money later

Seeking preventive care and making sure you’re up to date on annual wellness screenings is key, Bowman said.

Just because someone loses coverage doesn’t mean that illness goes away, too.

“The worst thing that we fear will happen is people avoiding care altogether, and that just leads to more sickness and higher costs down the road,” Bowman said.

Losing access to health insurance can also mean losing access to specialty doctors, needed prescriptions and other services like therapy.

Bowman said he recommends patients make sure things like annual checkups are done and prescriptions filled beforehand, in case there’s a delay as the state processes Medicaid applications.

“Get in and get any preventative services done that they need to have done,” Bowman said. “Get their prescriptions refilled in case there’s any delays.”

State estimates cited by Fernando indicate that between 250,000 and 500,000 Illinoisans could be affected by changes to Medicaid eligibility and enrollment requirements over time.

She said the largest population size likely to be affected is working adults without dependents.

“There definitely is some anticipation and some anxiety around the changes,” she said. “[…] As far as financial struggles and losing coverage, that’s why it’s so important to be proactive. We have time right now for individuals to understand what their coverage status is, what population they fall into and what they’re going to have to do to retain that coverage.”